Available online 1 February 2023, 100576
Author links open overlay panel, , , Highlights•Nepal is preparing for elimination by 2026.
•Spatial variation in temporal trend method used to detect and generate unusually high or low temporal trend of malaria indicators.
•Indigenous malaria increasing by 113.71% and imported malaria increasing by 156.22% in two different clusters.
•All indicators have clusters of increasing malaria trend.
•The decreasing clusters also have rate of decrease lower than outside the clusters.
AbstractNepal aims to eliminate malaria by 2026. This study analyzed district-level spatio-temporal patterns of malaria in Nepal from 2005 to 2018, following the introduction of Long-Lasting Insecticidal Nets (LLINs) for vector control intervention. The spatial variation in a temporal trend (SVTT) method in SaTScan was used to detect significantly high or low temporal trends of five malaria indicators: Indigenous, Imported, PV (Plasmodium vivax), PF (Plasmodium falciparum), and Total Malaria; results were mapped as clusters with associated trends. Spatial clusters of increasing malaria were found for all five indicators. Indigenous Malaria increased 113.71% in a cluster of three previously non-endemic mountainous districts. The most prominent cluster of Imported Malaria increased by 156.22%, and included the capital, Kathmandu. While some clusters had decreasing malaria, the rate of decrease in clusters was lower than outside the clusters. Overall, malaria burden is decreasing in Nepal as the country progresses closer to the elimination deadline. However, spatial clusters of increasing malaria, and clusters of lower rates of decreasing malaria, point to a need to focus vector control interventions on these clusters.
KeywordsMalaria elimination
Nepal
Spatial Variation
Temporal Trend
Spatio-temporal pattern
Control intervention
AbbreviationsLLINsLong-Lasting Insecticidal Nets
WHOWorld Health Organization
GMEPGlobal Malaria Eradication Project
DDTDichloro-diphenyl trichloroethane
IRSIndoor Residual Spraying
VDCsVillage Development Committees
GISGeographic Information System
DoHSDepartment of Health Services
EDCDEpidemiology and Disease Control Division
CBSCentral Bureau of Statistics
ICIMODInternational Center for Integrated Mountain Development
SVTTSpatial Variation in Temporal Trend
GFTAMGlobal Fund for Tuberculosis, AIDS, and Malaria
ACTArtemisinin-based Combination Therapy
Data AvailabilityAll data are described in the paper and websites made available.
© 2023 The Author(s). Published by Elsevier Ltd.
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